Medical Disclaimer
The information on this page is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.
Always seek the advice of your doctor or other qualified health professional with any questions you may have regarding a medical condition.
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Bones & Joints
Information about fractures, arthritis, joint replacements, and bone injuries
Shoulder
AC Joint Injuries in Athletes
AC joint separation (shoulder separation) occurs when ligaments connecting collarbone to shoulder blade tear, graded Type I-VI by Rockwood classification - most common in contact sports and cycling falls
Separated Shoulder (AC Joint Injury)
An AC joint separation is a common shoulder injury where the collarbone becomes partially or completely separated from the shoulder blade. Learn about the different grades of injury, treatment options from rest to surgery, and what to expect during recovery.
Shoulder Dislocation and Instability
Shoulder instability causes your shoulder to slip out of place or feel like it's giving way. Learn about dislocations, Bankart lesions, arthroscopic surgery, recurrence rates, and return to sport.
Bankart Lesion (Shoulder Labrum Tear)
A Bankart lesion is a tear of the shoulder labrum (cartilage rim) that occurs with shoulder dislocations. Learn about symptoms, when surgery is needed, arthroscopic repair, and return to sport.
Biceps Tendon Problems (Shoulder)
Biceps tendon inflammation, fraying or tears cause front shoulder pain - common in overhead athletes and middle-aged adults, treatment ranges from rest to surgical tenotomy or tenodesis
Brachial Plexus Birth Injury (Erb's Palsy)
Nerve injury to baby's arm during difficult delivery causing weakness or paralysis - most recover with physiotherapy by age 2, severe cases may need nerve surgery or tendon transfers
Broken Collarbone (Clavicle Fracture)
Collarbone fractures are very common injuries from falls or sports. Learn about sling vs surgery, when you need an operation, healing time, and return to activities.
Shoulder Impingement (Subacromial Pain)
Shoulder impingement, also called subacromial impingement, occurs when the rotator cuff tendons in your shoulder get pinched and irritated under the acromion bone (roof of your shoulder)—usually from bone spurs, thickened ligaments, or repetitive overhead activities—causing pain when lifting your arm to the side (especially between 60-120 degrees) and often worse at night. Most people (70-80%) improve with 3-6 months of physiotherapy and occasional corticosteroid injections, but if conservative treatment fails, keyhole surgery to shave the bone spur and create more space (subacromial decompression) has 85-90% success rates for relieving pain.
Broken Shoulder Socket (Glenoid Fracture)
Glenoid fractures are rare but serious breaks in your shoulder socket (the concave part of the shoulder blade that the ball of your arm bone sits in), almost always from high-energy trauma like motor vehicle accidents, falls from height, or severe sports injuries—often occurring together with shoulder dislocation. Most minimally displaced fractures heal well with sling immobilization for 3-4 weeks followed by physiotherapy, but significantly displaced fractures (especially those affecting the joint surface or causing shoulder instability) require surgery to realign and fix the bone with plates and screws, followed by 4-6 months recovery with risk of permanent shoulder stiffness and post-traumatic arthritis affecting 30-40% of patients.
Internal Shoulder Impingement
Internal shoulder impingement causes pain in throwing athletes when the rotator cuff and labrum rub together with the arm overhead. Learn about symptoms, GIRD, physiotherapy, and surgical options.
Proximal Biceps Tendon Rupture (Popeye Deformity)
Proximal biceps tendon rupture is a complete tear of the long head of the biceps tendon at the shoulder, causing sudden anterior shoulder pain (often described as a 'pop'), immediate weakness, and a characteristic distal bulge of the biceps muscle in the upper arm known as the 'Popeye deformity' or 'Popeye sign' from the muscle retracting distally when the proximal anchor is lost. The long head of biceps (LHB) tendon originates from the superior labrum inside the shoulder joint, travels through the bicipital groove of the humerus, and joins the short head to form the biceps muscle belly—when the LHB ruptures proximally (95% of biceps ruptures, vs 5% distal biceps), the muscle retracts down the arm creating the visible bulge. Risk factors include age over 40 years, chronic biceps tendinopathy, rotator cuff tears (50-60% association), corticosteroid injections, smoking, and overhead activities. Despite dramatic appearance, functional loss is surprisingly mild (10-20% loss of supination strength, 5-10% loss of elbow flexion strength) because the short head of biceps remains intact and compensates. Treatment options include conservative management (acceptable for sedentary individuals and elderly patients—90% satisfactory outcomes despite cosmetic deformity), biceps tenotomy (simple release allowing further retraction—quick recovery but persistent cosmetic deformity and 10-20% risk of muscle cramping), or biceps tenodesis (reattaching tendon to humerus restoring length-tension relationship—best cosmetic and functional outcomes 85-95% but longer recovery 4-6 months and higher complication rate 10-15%).
Shoulder Fractures (Proximal Humerus Fractures)
Proximal humerus fractures are breaks in the upper arm bone near the shoulder joint, most commonly occurring in elderly people after falls due to osteoporosis - they cause severe shoulder pain, swelling, bruising, and inability to move the arm, with treatment ranging from sling immobilization for simple fractures (80-85% of cases healing well conservatively in 6-12 weeks) to surgical fixation with plates or shoulder replacement for displaced or unstable fractures.
Reverse Hill-Sachs Lesion (Posterior Shoulder Dislocation Injury)
A reverse Hill-Sachs lesion is a dent or compression fracture in the front of the humeral head (shoulder ball) caused by posterior shoulder dislocation, where the shoulder ball jams against the back of the socket creating a permanent divot - it's much less common than regular Hill-Sachs lesions (from anterior dislocations) and may cause recurrent posterior instability requiring surgical repair if the defect involves more than 25% of the joint surface.
Reverse Shoulder Replacement (Reverse Total Shoulder Arthroplasty)
Reverse shoulder replacement is a specialized joint replacement surgery where the ball and socket of the shoulder are switched from their normal positions, designed for patients with severe rotator cuff tears and arthritis (cuff tear arthropathy) or complex fractures in elderly patients - the reversed design allows the deltoid muscle to lift the arm instead of the torn rotator cuff, providing excellent pain relief (90-95% success) and functional improvement in patients over 65 years old.
Rotator Cuff Tear Arthropathy (Cuff Arthropathy)
Rotator cuff tear arthropathy is a severe shoulder condition where a long-standing massive rotator cuff tear causes the shoulder ball to migrate upward and develop arthritis from rubbing against the acromion bone, resulting in severe pain, inability to lift the arm (pseudoparalysis), and shoulder weakness - it occurs in about 4-20% of patients with massive chronic rotator cuff tears and typically requires reverse shoulder replacement surgery for pain relief and functional improvement.
Massive Rotator Cuff Tears
Massive rotator cuff tears involve two or more complete tendon tears (or one very large tear more than 5cm), causing significant shoulder weakness, difficulty lifting the arm overhead, and night pain - they occur in about 10-40% of all rotator cuff tears and are more challenging to repair, with treatment options ranging from physiotherapy and partial repairs to reverse shoulder replacement depending on age, activity level, and muscle quality.
Rotator Cuff Tears
A rotator cuff tear happens when the tendons connecting your shoulder muscles to bone are damaged. Learn about symptoms, when surgery is needed, and how to manage shoulder pain.
Scapula Fractures (Shoulder Blade Fracture)
Scapula fractures are breaks in the shoulder blade bone, rare injuries accounting for only 1% of all fractures, typically caused by high-energy trauma (car accidents, motorcycle crashes, falls from height) - most scapula body and spine fractures (85-90%) heal well with sling immobilization and physiotherapy, while displaced glenoid (shoulder socket) fractures or severely displaced body fractures may require surgical fixation.
Scapular Dyskinesis (Abnormal Shoulder Blade Movement)
Scapular dyskinesis is abnormal movement or positioning of the shoulder blade (scapula) during arm motion, causing visible winging, shoulder pain, and reduced athletic performance - it affects 60-100% of athletes with shoulder injuries and results from muscle imbalances, poor posture, or nerve injuries, with treatment focused on physiotherapy targeting scapular stabilizing muscles achieving 70-90% improvement in 3-6 months.
Shoulder Arthrodesis (Shoulder Fusion Surgery)
Shoulder arthrodesis is a salvage surgery that permanently fuses the shoulder joint to eliminate pain when all other treatment options have failed - it's reserved for severe end-stage shoulder problems like failed shoulder replacements with massive bone loss, irreparable rotator cuff tears causing pseudoparalysis in young patients, or chronic shoulder infections, achieving 80-90% pain relief but eliminating shoulder movement and forcing reliance on scapular (shoulder blade) motion for arm positioning.
Shoulder Replacement Complications
Shoulder replacement surgery complications occur in 5-15% of cases and include instability (dislocation - most common in reverse shoulder replacements), infection requiring implant removal, glenoid component loosening, nerve injury causing weakness, and periprosthetic fractures - while most patients have excellent outcomes, recognizing complications early and seeking prompt treatment is critical for salvage and preserving shoulder function.
Shoulder Replacement Infection
Shoulder replacement infection is a serious complication occurring in 1-2% of shoulder replacement surgeries when bacteria contaminate the implant during surgery or spread through the bloodstream later - it causes severe shoulder pain, fever, wound drainage, and redness weeks to months after surgery, requiring aggressive treatment with two-stage revision surgery (removing infected implant, treating infection for 6-12 weeks, then reimplanting new shoulder replacement) which successfully eradicates infection in 80-90% of cases.
Dislocated Shoulder
Shoulder dislocations are very common sports injuries. Learn about emergency treatment, recurrence risk, when you need surgery, and preventing re-dislocation.
Shoulder Fracture-Dislocations
Shoulder fracture-dislocations are complex injuries combining shoulder dislocation (ball coming out of socket) with fractures of the shoulder bones - most commonly the humeral head (ball), glenoid rim (socket edge), or greater tuberosity (bone bump where rotator cuff attaches) - these injuries occur from high-energy trauma (motor vehicle accidents, falls from height, seizures) causing severe pain, obvious deformity, and inability to move the shoulder, requiring emergency reduction in the emergency department followed by CT scan to assess fracture patterns and determine if surgery is needed to fix displaced bone fragments.
Shoulder Hemiarthroplasty (Partial Shoulder Replacement)
Shoulder hemiarthroplasty is partial shoulder replacement surgery where only the humeral head (ball) is replaced with a metal prosthesis while leaving the natural glenoid (socket) intact - it is primarily used for complex proximal humerus fractures in elderly patients and avascular necrosis of the humeral head with healthy glenoid cartilage - however, modern practice is shifting toward reverse total shoulder replacement for most indications because hemiarthroplasty outcomes are less predictable, with 30-40% developing progressive glenoid erosion and persistent pain requiring conversion to total shoulder replacement within 10 years.
Shoulder Arthritis (Glenohumeral Osteoarthritis)
Shoulder osteoarthritis (glenohumeral arthritis) is progressive wear and tear of the cartilage lining the shoulder ball and socket joint, causing deep shoulder pain, stiffness, grinding sensation with motion, and night pain disrupting sleep - it occurs from aging (primary osteoarthritis), previous injuries (post-traumatic arthritis), rotator cuff tears (cuff tear arthropathy), or avascular necrosis - treatment ranges from physiotherapy and injections for mild arthritis to shoulder replacement surgery for severe disease, with 90-95% of patients achieving excellent pain relief and improved function after total shoulder replacement.
SLAP Tears (Shoulder Labrum Tear)
SLAP tears (Superior Labrum Anterior to Posterior) are tears of the cartilage rim at the top of the shoulder socket where the biceps tendon attaches - they commonly occur in overhead athletes from repetitive throwing or in older adults from degeneration, causing deep shoulder pain, clicking, and weakness with overhead activities, with treatment ranging from physiotherapy for mild degenerative tears to arthroscopic surgery for young athletes with Type II tears.
Foot
Accessory Navicular (Extra Bone in Foot)
An accessory navicular is an extra bone on the inside of your foot that can cause pain, especially during activity. Learn about symptoms, non-surgical treatments, and when surgery (Kidner procedure) might be needed.
Fifth Metatarsal Stress Fracture (Outside Foot Bone)
Fifth metatarsal stress fractures are overuse injuries affecting the long bone on the outside of your midfoot, particularly common in runners, dancers, and basketball players—causing gradual onset of outside foot pain that worsens with activity. The Jones fracture (break at the base of this bone where blood supply is poor) is especially problematic with high failure rates (30%) when treated non-surgically, making many athletes choose surgery with screw fixation for faster healing (6-8 weeks back to sport) versus 12-20 weeks in a boot with significant risk of not healing at all, requiring delayed surgery anyway.
Flat Feet in Children (Flexible Flatfoot)
Flexible flatfoot is extremely common in children (affecting up to 20% of kids), where the arch of the foot flattens when standing but reappears when standing on tiptoes or sitting—most cases are completely normal and improve naturally as the child grows, requiring no treatment at all. Only symptomatic flatfeet causing pain or difficulty with activities need intervention (usually supportive shoes or physiotherapy), and despite widespread use of custom orthotics, strong evidence shows they don't change the natural course of flexible flatfeet or prevent problems in adulthood, making them unnecessary for most children who have no pain.
Jones Fracture (Break at Base of 5th Toe Bone)
A Jones fracture is a specific break at the base of the fifth metatarsal (the long bone connecting to your little toe), occurring 1.5-3cm from the bone end in a zone with poor blood supply, typically from twisting injury on outside of foot, sudden pivoting in basketball/football, or repeated stress in runners and dancers—causing pain, swelling, and difficulty walking on outside of foot. Jones fractures are notorious for slow healing and high nonunion rate (20-30% fail to heal with boot/cast alone) due to poor blood supply to this zone, making surgical screw fixation the preferred treatment for athletes and active individuals (90-95% union rate, return to sport 6-10 weeks), while non-surgical treatment reserved for low-demand patients willing to accept longer recovery (12-20 weeks) and risk of nonunion requiring delayed surgery.
Bunions in Children and Teens (Juvenile Hallux Valgus)
Juvenile hallux valgus is a bunion deformity (big toe angling toward second toe with bony bump on inside of foot) developing in children and adolescents (typically ages 10-15), often with strong family history and associated with flexible flatfeet or ligament laxity—causing pain, difficulty fitting shoes, and cosmetic concern. Unlike adult bunions which are progressive and degenerative, juvenile bunions often have underlying structural factors (metatarsus primus varus—inward angling of first metatarsal bone). Non-surgical management (wide shoes, avoiding heels, padding) is preferred until skeletal maturity due to high recurrence rates (30-50%) with early surgery. Surgery considered for persistent symptoms after skeletal maturity (age 14-16+ in girls, 16-18+ in boys) has better success but still higher recurrence than adult bunion surgery.
Broken Metatarsal (Broken Foot Bone)
Metatarsal fractures are breaks in the long bones of your forefoot. Learn about stress fractures, Jones fractures, treatment with walking boot or surgery, and when you can walk and return to sport.
Stress Fractures of the Foot Bones
Metatarsal stress fractures are tiny cracks in the long bones of the foot caused by repetitive impact from running, jumping, or marching - the second metatarsal is most commonly affected (called 'marching fracture' from military recruits), while fifth metatarsal base fractures (Jones fractures) are high-risk due to poor blood supply - most stress fractures heal with 6-8 weeks in a walking boot and activity modification (95%+ success), but Jones fractures often require surgery with screw fixation to prevent nonunion, especially in athletes.
Curved Baby Foot (Metatarsus Adductus)
Metatarsus adductus is a common pediatric foot deformity where the forefoot (toes and front part of foot) curves inward toward the midline while the heel remains in normal position—creating a 'C-shaped' or 'banana-shaped' foot appearance when viewed from the sole. This is the most common congenital foot deformity (affecting 1-2 per 1,000 births), typically noticed at birth or in the first few months of life, and thought to result from intrauterine positioning (tight space in womb). The condition ranges from flexible (foot can be passively straightened to neutral) to rigid (foot cannot be straightened), with flexibility being the key determinant of treatment and prognosis. Most mild-to-moderate flexible cases (85-90%) resolve spontaneously by 12-18 months with observation and stretching, while moderate rigid or severe deformities may require serial casting or rarely surgery (in persistent cases after age 4-5 years). Metatarsus adductus is distinguished from clubfoot (more severe, involves ankle and hindfoot) and must be differentiated from skewfoot (serpentine foot with hindfoot valgus).
Broken Midfoot Bone (Navicular Fracture)
Navicular fractures are breaks in the navicular bone—a boat-shaped bone in the midfoot (between ankle and toes) critical for foot arch stability—occurring as either acute fractures from trauma (fall, twist, or crush injury) or stress fractures from repetitive loading (common in athletes, military recruits). Acute navicular fractures present with severe midfoot pain, swelling, and inability to bear weight, often associated with other midfoot injuries. Stress fractures present with insidious pain over weeks/months, worsened by running or impact activities. Navicular fractures are concerning because of poor blood supply to central third of bone (high nonunion risk 10-30% if treated conservatively) and critical role in foot arch mechanics. Treatment depends on fracture type: undisplaced stress fractures require 6-8 weeks non-weight-bearing in boot/cast (to allow healing in poorly vascularized bone), displaced acute fractures or high-risk stress fractures require surgery (screw fixation) with 85-90% union rates when treated appropriately.
Pseudo-Jones Fracture (5th Metatarsal Avulsion)
Pseudo-Jones fractures are small chip fractures at the base of the 5th metatarsal (outside of midfoot) caused by ankle rolling inward, pulling off a piece of bone where the peroneal tendon attaches - unlike true Jones fractures which have poor healing, pseudo-Jones fractures heal well in 95% of cases with simple walking boot or stiff-soled shoe for 4-6 weeks, returning to activities in 6-8 weeks.
Sesamoid Fractures (Broken Bones Under Big Toe)
Sesamoid fractures are breaks in two tiny pea-sized bones embedded in the tendon under the big toe joint - they can occur from acute injury (stubbing toe, landing from jump) or as stress fractures in dancers and athletes who repetitively load the forefoot, causing pain and tenderness under the ball of the foot that worsens with push-off, with treatment usually involving 6-8 weeks of offloading in a walking boot achieving 70-80% healing, but some require surgical removal if conservative treatment fails.
Sesamoiditis (Inflammation of Bones Under Big Toe)
Sesamoiditis is inflammation and irritation of the sesamoid bones and surrounding tendons under the big toe joint, caused by repetitive pressure and overuse from activities like dancing, running, or wearing high heels - it causes gradual-onset forefoot pain that worsens with walking or push-off, typically responding well to conservative treatment with offloading pads, stiff-soled shoes, and activity modification achieving 80-90% pain relief within 6-8 weeks.
Tarsal Coalition (Rigid Flatfoot in Children)
Tarsal coalition is an abnormal bony, cartilaginous, or fibrous connection between two or more of the tarsal bones (foot bones) - present from birth but typically becomes painful during adolescence (ages 8-16) when the coalition ossifies and restricts foot motion - it causes rigid flatfoot, ankle pain, recurrent sprains, and muscle spasms (peroneal spasm) - conservative treatment (custom orthotics, activity modification, short-leg walking cast) provides symptom relief in 50-60% of patients, while persistent symptoms are treated with surgery to remove the coalition (resection) achieving 70-80% good outcomes in well-selected cases.
Turf Toe
Turf toe is a sprain of your big toe joint, common in athletes. Learn about symptoms, treatment with rest and taping, and when surgery might be needed.
Hip
Hip Socket Fracture
An acetabular fracture is a break in the socket part of your hip joint. These serious injuries usually result from high-energy trauma like car accidents. Learn about symptoms, treatment options including surgery, and what to expect during recovery.
Hip Bone Death (Avascular Necrosis)
Avascular necrosis (AVN) is bone death from loss of blood supply to the hip. Learn about causes (steroids, alcohol), staging, core decompression surgery, and when hip replacement is needed.
Hip Impingement (CAM-Type FAI)
Femoroacetabular impingement (FAI) causes hip and groin pain in young, active people. Learn about cam and pincer types, symptoms, hip arthroscopy surgery, and return to sport.
Cerebral Palsy (Orthopaedic Management)
Cerebral palsy (CP) is a permanent movement and posture disorder caused by brain injury before, during, or shortly after birth, affecting 1 in 500 Australian children (approximately 34,000 Australians living with CP). While the underlying brain injury doesn't worsen, children with CP commonly develop orthopaedic complications including hip displacement (affecting 35% of all CP children and up to 90% of non-walkers), spinal deformity (scoliosis in 20-60% depending on severity), muscle contractures limiting joint movement, and foot/ankle deformities affecting gait. In Australia, children with CP are classified by the Gross Motor Function Classification System (GMFCS levels I-V, from independent walking to complete wheelchair dependence) and undergo regular hip surveillance with X-rays every 6-12 months to detect hip subluxation early when preventive surgery is most effective. Orthopaedic treatment focuses on maintaining mobility, preventing deformity, and improving function through physiotherapy, bracing, botulinum toxin injections for spasticity, and surgery when needed—with multilevel orthopaedic surgery able to significantly improve walking patterns in selected ambulatory children, and hip reconstruction preventing painful dislocation in non-ambulatory children.
Hip Dysplasia in Babies (DDH)
Hip dysplasia (DDH) is when a baby's hip joint doesn't form properly. Learn about screening, early detection with ultrasound, treatment from Pavlik harness to surgery, and what to expect for your child's development.
Hip Ball Fracture (Femoral Head Fracture)
Femoral head fractures are rare but serious breaks in the ball of your hip joint, almost always from high-energy trauma such as car accidents (dashboard injury when knee hits dashboard driving hip ball backward out of socket) or falls from height—typically occurring together with hip dislocation causing severe pain and inability to move the leg. These injuries require emergency treatment to relocate the hip within 6 hours, usually followed by surgery to fix broken bone fragments, but despite treatment carry high risks of complications including hip bone dying from loss of blood supply (20-30% develop avascular necrosis) and arthritis (40-50%), with many patients eventually needing hip replacement within 5-10 years.
Girdlestone Procedure (Hip Without Replacement)
Girdlestone procedure is removal of infected or failed hip replacement without inserting a new implant, leaving a false joint where scar tissue fills the space between femur and pelvis - this salvage operation is performed when infection cannot be cured with implant retention and patient is too frail/sick for complex two-stage revision, or after multiple failed revision attempts - patients walk with significant limp, leg shortening (3-5cm shorter), require walking stick or frame, but achieve pain-free mobility and eradication of infection in 70-80% of cases
Greater Trochanteric Pain Syndrome (Lateral Hip Pain)
Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain affecting middle-aged and older adults, particularly women - it was previously called 'trochanteric bursitis' but is now recognized as primarily gluteal tendinopathy (degeneration of gluteus medius and minimus tendons where they attach to the greater trochanter) with or without bursitis - GTPS causes pain over the outer hip bone, worse lying on the affected side at night, climbing stairs, and prolonged standing, improving with conservative treatment (activity modification, physiotherapy, corticosteroid injection) in 70-80% of patients within 3-6 months, though some cases become chronic requiring ongoing management or rarely surgery.
Bone Growing in Wrong Places (After Hip Surgery or Injury)
Heterotopic ossification (HO) is abnormal bone formation in soft tissues (muscles, tendons) where bone shouldn't normally form, most commonly occurring after hip replacement surgery (20-30% of patients), severe trauma, burns, or spinal cord injury—causing progressive joint stiffness, reduced range of motion, and sometimes pain. The bone grows over weeks to months after the triggering event. Prevention with NSAIDs (indomethacin) or single-dose radiation therapy after high-risk surgeries reduces HO by 70-80%. Established symptomatic HO can be surgically removed once mature (usually 12-18 months after onset), with 70-80% improvement in motion, though recurrence occurs in 10-20% despite preventive measures.
Shallow Hip Socket in Adults (Developmental Hip Dysplasia)
Adult hip dysplasia (developmental dysplasia of the hip, DDH) is a condition where your hip socket is too shallow to properly cover the ball of your hip joint, often undiagnosed in childhood but causing groin pain, hip instability, and labral tears in young adults (typically 20s-40s), particularly active women. The shallow socket causes abnormal hip mechanics and early wear of cartilage. Young patients with mild-moderate dysplasia and minimal arthritis may benefit from joint-preserving surgery (periacetabular osteotomy, PAO) which reorients the socket to better cover the ball—delaying or preventing hip replacement for 10-20+ years in 70-80% of well-selected patients. Advanced dysplasia with established arthritis requires total hip replacement, often at younger age than typical (30s-50s), with special technical considerations.
Hip Flexor Strain
Hip flexor strains cause pain in the front of your hip or groin with running, kicking, and lifting your knee. Learn about symptoms, rest protocols, physiotherapy exercises, and return to sport.
Hip Arthritis
Hip arthritis causes pain in your groin or thigh when the cartilage in your hip joint wears down. Learn about symptoms, treatment options from injections to hip replacement, and what you can do to manage your hip pain.
Hip Pointer Injury
Hip pointer is a painful bruise to the hip bone from direct impact in contact sports. Learn about symptoms, ice and rest protocols, protective padding, and return to sport timelines.
IT Band Syndrome (Runner's Knee)
IT band syndrome causes pain on the outside of your knee, especially in runners and cyclists. Learn about symptoms, treatment from stretching to physiotherapy, and how to prevent this common overuse injury.
Hip Labral Tears (Torn Cartilage in Hip Socket)
Hip labral tear - tear in ring of cartilage (labrum) lining hip socket causing groin pain, clicking, catching, giving way. Most common in young active adults (20-40s), athletes, dancers. Often caused by femoroacetabular impingement (FAI - abnormal hip bone shape pinching labrum with movement). Symptoms: deep groin pain with sitting, walking, twisting, positive C-sign (grab front of hip with thumb and fingers forming C-shape), clicking or catching sensation. Diagnosis: MRI arthrogram (dye injection) shows tear. Treatment: conservative management (physiotherapy, activity modification) often fails for significant tears. Hip arthroscopy (keyhole surgery) repairs or trims torn labrum and corrects FAI bone abnormality. Recovery 4-6 months return to activities, 6-12 months full sport. Outcomes: 80-90% good results if FAI corrected in young active patients, poorer outcomes if degenerative tears in older patients with arthritis.
Hip Blood Supply Problem in Children (Perthes Disease)
Legg-Calvé-Perthes disease is a childhood hip condition where blood supply to the ball of the hip joint (femoral head) is temporarily interrupted, causing the bone to die (avascular necrosis) and then slowly regenerate over 2-4 years, typically affecting children ages 4-8 years (boys 4-5 times more common than girls)—presenting with limping, hip/groin pain, and limited hip motion. The disease goes through predictable stages (necrosis, fragmentation, reossification, remodeling) with treatment focused on 'containment'—keeping the softened femoral head centered in the hip socket so it heals round rather than flat. Most children with good containment achieve satisfactory long-term hip function, though 30-40% develop hip arthritis in adulthood (usually 40s-50s), earlier than normal population.
Hip Fracture (Broken Hip)
A hip fracture is a break in the thigh bone near the hip joint - a serious injury that almost always requires surgery. Learn about treatment, recovery, and what to expect after breaking your hip.
Severe Pelvic Ring Injury (Open Book Pelvic Fracture)
Open book pelvic fractures are severe, life-threatening pelvic ring injuries where external rotation forces cause the pelvis to 'open like a book'—disrupting the pubic symphysis (front of pelvis) and often the sacroiliac joints or sacrum (back of pelvis), classified as APC-II or APC-III (Anterior-Posterior Compression) injuries in the Young-Burgess classification. These high-energy injuries typically result from motor vehicle accidents, pedestrian vs car collisions, or motorcycle crashes, presenting with massive pelvic instability and life-threatening hemorrhage from torn pelvic venous plexus and arterial bleeding (mortality 10-20% in severe cases despite modern trauma care). Immediate management focuses on hemorrhage control using pelvic binder application, resuscitation, and emergency pelvic stabilization (external fixator or emergent ORIF), followed by definitive surgical fixation once patient stabilized. These injuries often occur as part of polytrauma (multiple injuries) and require multidisciplinary trauma team management in specialized trauma centers, with long-term outcomes depending on associated injuries (bladder/urethral trauma, nerve injuries, blood loss) and quality of pelvic reduction and fixation.
How Osteoarthritis Develops
Patient-friendly explanation of how osteoarthritis develops - from healthy cartilage to worn joints - including what happens inside the joint, why it causes pain, and what drives disease progression
Periprosthetic Hip Fracture
Comprehensive patient guide to fractures around hip replacements - Vancouver classification, surgery options, recovery timeline, and preventing fractures after hip replacement
Pincer Hip Impingement (Hip Socket Over-Coverage)
Pincer FAI - hip socket (acetabulum) over-covers ball of hip joint causing pinching of labrum and cartilage with movement. More common in middle-aged athletic women (30-50s), dancers, gymnasts. Excessive socket coverage (deep socket or retroverted tilted backward) causes edge of socket to contact femoral neck with hip flexion, crushing labrum rim. Symptoms: deep groin pain with sitting/walking/sports, reduced hip flexion and internal rotation, C-sign. Diagnosis: X-rays show crossover sign (anterior wall crosses posterior wall), prominent anterior wall, lateral center-edge angle over 40 degrees. MRI arthrogram shows labral tears at anterosuperior labrum (front-top rim where pinching occurs). Treatment: activity modification and physiotherapy first 3-6 months (30-50% improve). Surgery: hip arthroscopy with acetabuloplasty (trim excessive socket rim) and labral repair. Outcomes: 75-85% good results if young (under 40) with minimal arthritis and both pincer correction + labral repair performed. Poorer outcomes (50-60%) if age over 50 or arthritis present. Often coexists with cam FAI (mixed FAI 85% of cases) requiring correction of both bone abnormalities.
Proximal Hamstring Tears (High Hamstring Injury)
Proximal hamstring injuries involve tears or degeneration of the hamstring tendons where they attach to the sitting bone (ischial tuberosity) in the buttock, causing deep buttock pain, difficulty sitting, and weakness with running or bending - they occur from sudden sprinting in athletes or gradual overuse in runners, with treatment ranging from rest and physiotherapy for partial tears (70-80% successful) to surgical reattachment for complete tears or failed conservative treatment.
Septic Arthritis of the Hip (Hip Infection in Children)
Septic arthritis of the hip in children is a bacterial infection inside the hip joint causing severe pain, refusal to walk, and high fever - it's a pediatric orthopedic emergency requiring urgent surgical drainage within 12-24 hours to prevent permanent hip damage and avascular necrosis (death of the hip ball), with treatment involving emergency open hip washout and IV antibiotics achieving 90% excellent outcomes if treated promptly, but can cause lifelong hip problems if diagnosis delayed.
Sickle Cell Disease and Bone Problems
Sickle cell disease causes multiple bone and joint problems due to abnormal blood cells blocking blood vessels - the most common issues are avascular necrosis (death of hip or shoulder ball from blood supply loss affecting 50% of patients by age 35), bone pain crises (acute episodes mimicking infection), and increased infection risk particularly Salmonella bone infections, requiring specialized orthopedic care including early surgery for AVN and careful perioperative management.
Slipped Capital Femoral Epiphysis (Hip Growth Plate Slip in Teens)
Slipped capital femoral epiphysis (SCFE) occurs when the ball of the hip (femoral head) slips backward off the growth plate during adolescence - it most commonly affects overweight teenagers aged 10-16 years during rapid growth spurts, causing hip, groin, or knee pain and limping, requiring urgent surgery within 24 hours to pin the femoral head in place and prevent catastrophic complications like avascular necrosis.
Upper Thigh Fractures (Subtrochanteric Fractures)
Subtrochanteric fractures are breaks in the upper thigh bone (femur) just below the hip joint - most occur in elderly people with osteoporosis from low-energy falls or in younger people from high-energy trauma (car accidents, falls from height), typically requiring surgery with a metal rod and screws (intramedullary nail) inserted down the center of the thigh bone to stabilize the fracture - recovery takes 3-6 months with gradual weight-bearing progression, though some patients develop healing complications (non-union) requiring further surgery, particularly those taking long-term bisphosphonate medications who develop atypical fractures with unique fracture patterns
Lower Leg
Achilles Tendinopathy (Achilles Tendon Pain)
Achilles tendinopathy causes pain and stiffness in the back of your ankle, common in runners and active people. Learn about eccentric exercises, treatment options, and recovery timelines.
Compartment Syndrome (Surgical Emergency)
Compartment syndrome is a surgical emergency causing severe pain and limb-threatening damage. Learn about the 5 Ps warning signs, fasciotomy surgery, and why immediate treatment is critical to save your limb.
Blood Clots After Orthopaedic Surgery (DVT/PE)
Deep vein thrombosis (DVT) is a blood clot forming in leg veins after surgery, while pulmonary embolism (PE) occurs when that clot breaks off and travels to lungs blocking blood flow - DVT affects 1-3% of hip/knee replacement patients despite prevention measures (was 15-30% before modern blood thinners), causing leg swelling, pain, and warmth, while PE affects 0.1-0.5% causing shortness of breath, chest pain, and can be life-threatening - prevention includes blood thinners (aspirin, rivaroxaban, enoxaparin), compression stockings, and early walking after surgery
Ankle Growth Plate Fractures in Teenagers
Ankle growth plate fractures occur in the lower shin bone near the ankle in children and teenagers (ages 10-16), caused by sports injuries, falls, or twisting injuries - the growth plate is the weak point in growing bones where new bone forms - these fractures cause ankle pain, swelling, and difficulty walking - treatment ranges from casting (4-6 weeks) for simple fractures to surgery for displaced fractures, with excellent outcomes in 85-95% of cases and low risk of growth problems if treated promptly
Shin Splints (Medial Tibial Stress Syndrome)
Medial tibial stress syndrome (MTSS), commonly known as 'shin splints,' is an overuse injury causing pain along the inside (medial) border of the shin bone (tibia), typically in the lower two-thirds of the leg, resulting from repetitive stress on the bone and surrounding muscles/tendons during running, jumping, or high-impact activities. This is one of the most common running injuries (accounting for 10-15% of all running injuries), developing from accumulated microtrauma to the periosteum (bone lining) and surrounding soft tissues when training volume or intensity increases too rapidly ('too much too soon'). MTSS presents as diffuse, aching pain along the inside shin during activity—initially only during exercise, then progressing to pain before/after exercise if not treated. It differs from stress fractures (focal point tender pain) and compartment syndrome (tight, swollen calf muscles). Treatment focuses on relative rest, addressing training errors and biomechanical factors (pronation, weak hips), with 85-90% resolution in 4-8 weeks with conservative management, though 10-15% develop stress fractures if they continue training through pain.
Osteoid Osteoma (Benign Bone Tumor Causing Night Pain)
Benign bone tumor (non-cancerous growth) causing severe night pain relieved by aspirin or NSAIDs - small nidus (5-15mm) produces prostaglandins causing characteristic pain pattern, most common in long bones of adolescents and young adults, cured by radiofrequency ablation (95% success) or surgical excision
High Ankle Sprains (Syndesmotic Injuries)
Syndesmotic injuries (high ankle sprains) are tears of the ligaments connecting the two lower leg bones (tibia and fibula) just above the ankle - less common than regular ankle sprains (10% of all ankle injuries) but more serious, occurring from external rotation (twisting foot outward) or hyperdorsiflexion (excessive upward bending) during sports like rugby, AFL, skiing - most require 6-12 weeks immobilization in a walking boot, though severe unstable injuries require surgery with screws or flexible fixation devices to hold the bones together while ligaments heal, with return to sport typically 3-6 months due to risk of chronic ankle instability if healing inadequate
Broken Shin Bone (Tibia Fracture)
Tibial shaft fractures are breaks in the main shin bone (tibia) between the knee and ankle - they commonly result from high-energy injuries like motor vehicle accidents or sports injuries, and cause severe pain, swelling, inability to walk, and visible deformity - open fractures (bone breaking through skin) occur in 20-30% of cases due to thin soft tissue covering the shin bone - treatment depends on fracture stability: minimally displaced fractures can be treated with casting (4-6 months healing), while displaced or unstable fractures require surgery with intramedullary nail (rod down center of bone) or plate fixation achieving 85-90% union.
Knee
ACL Injuries (Anterior Cruciate Ligament Tear)
An ACL tear is a common knee injury, especially in sports. Learn about symptoms, surgical and non-surgical treatment options, recovery timelines, and return to sport.
ACL Reconstruction Surgery
ACL reconstruction uses tendon graft (hamstring, patellar tendon, or donor tissue) to rebuild torn ACL - success rate 85-95% but 9-12 month recovery, graft choice affects outcomes and complications
Articular Cartilage Damage (Chondral Defects)
Damage to smooth cartilage covering joint surfaces (most commonly knee) from trauma, overuse, or osteochondritis dissecans - cartilage cannot heal naturally and leads to arthritis if untreated, treatment options include microfracture, cartilage transplant, or cell-based repair
Knock Knees and Bow Legs in Children
Genu varum (bow legs) and genu valgum (knock knees) are angular knee deformities in children that follow a normal developmental pattern - bow legs are normal from birth to age 2 years, knees straighten by age 2-3, then knock knees peak at age 3-4 years before gradually correcting by age 7-8 - most cases are physiological (normal development) resolving without treatment, but pathological deformities from Blount disease (abnormal growth plate causing progressive bowing), rickets (vitamin D deficiency), or skeletal disorders require treatment with observation, vitamin D supplementation, bracing, or surgery (guided growth with temporary plates or corrective osteotomy) depending on severity and underlying cause.
Childhood Arthritis Affecting Joints (Juvenile Idiopathic Arthritis)
Juvenile idiopathic arthritis (JIA) is a group of chronic inflammatory joint diseases affecting children under 16 years, causing joint pain, swelling, stiffness (especially morning stiffness lasting more than 30 minutes), and potential long-term joint damage if untreated. Primary management is medical (with pediatric rheumatologist using medications like methotrexate, biologics) to control inflammation and prevent joint destruction. Orthopedic surgeons become involved when medical treatment alone cannot prevent complications: joint contractures (permanent stiffness) requiring soft tissue releases, leg length discrepancies from growth disturbances requiring guided growth surgery, and severe joint destruction in adolescents/young adults requiring joint replacements (hip, knee)—typically in 10-15% of JIA patients who have poorly controlled disease despite modern medications.
Knee Fusion Surgery (Knee Arthrodesis)
Knee arthrodesis is a salvage surgery that permanently fuses (locks) your knee joint in a straight or near-straight position, creating a solid bone connection between femur (thigh bone) and tibia (shin bone), eliminating knee motion but providing pain-free, stable weight-bearing. This major procedure is reserved for situations where knee replacement is not possible or has failed multiple times—typically after severe infection requiring implant removal, multiple failed knee replacements with poor bone stock, or young patients with destroyed knees unsuitable for replacement. While it eliminates knee pain (90-95% success), it creates permanent disability requiring compensatory hip/ankle motion and assistive devices, making it a last-resort option when the alternative is amputation or permanent non-weight-bearing.
Knee Arthritis
Knee arthritis causes pain and stiffness when the cartilage in your knee joint wears down. Learn about symptoms, treatment options, and what you can do to manage your knee pain.
MCL Injury (Medial Collateral Ligament Sprain)
MCL injury is a sprain of the ligament on the inner side of the knee. Learn about grades of injury, non-surgical treatment versus surgery, and what to expect during recovery.
Ramp Lesions (Hidden Meniscus Tears with ACL Injuries)
Meniscal ramp lesions are tears between the back of the medial meniscus (inner knee cartilage cushion) and the joint capsule - they occur in 40-60% of ACL (anterior cruciate ligament) tears but are often missed on MRI and even during knee arthroscopy if not specifically looked for - ramp lesions cause persistent knee pain, swelling, and giving way similar to ACL instability - they should be repaired during ACL reconstruction surgery using sutures to reattach the meniscus to the capsule, achieving 85-90% healing and preventing later meniscus degeneration.
Meniscal Repair Surgery
Comprehensive patient guide to meniscal repair surgery for knee cartilage tears - surgical techniques, healing success rates, recovery timeline, and when repair is better than removal
Meniscus Anchor Tear (Meniscal Root Tear)
Meniscal root tears are complete detachments of the meniscus (cartilage cushion in the knee) from its attachment point (root) to the tibia (shin bone), most commonly affecting the posterior (back) root of the medial (inside) meniscus in patients over 50 years. These tears are biomechanically equivalent to having no meniscus at all—when the root detaches, the meniscus loses its ability to distribute load across the knee, causing stress concentration on underlying cartilage similar to total meniscectomy (complete meniscus removal). This leads to rapid cartilage degeneration and knee arthritis if untreated. Medial meniscus posterior root tears (MMPRT) typically occur from degenerative changes (age-related weakening of root attachment) or acute trauma, presenting as acute knee pain, swelling, and difficulty bearing weight—often misdiagnosed as simple meniscus tear or arthritis. MRI shows characteristic 'ghost meniscus' sign (meniscus extruded or pushed out from joint). Treatment options include conservative management (acceptable for low-demand patients but leads to arthritis progression) or surgical root repair (transtibial pull-out technique) which can slow arthritis progression and relieve pain in 70-80% of patients, though cannot reverse existing cartilage damage.
Meniscal Transplantation
Surgical replacement of removed meniscus cartilage with donor tissue to reduce knee pain and delay arthritis in young active patients who previously had meniscus removed
Meniscus Tears (Torn Cartilage in Knee)
A meniscus tear is a common knee injury affecting the cartilage cushion. Learn about symptoms, when surgery is needed versus physiotherapy, and what to expect during recovery.
Cartilage Repair Surgery (Microfracture)
Microfracture is a surgical cartilage repair technique used to treat focal articular cartilage defects (areas of damaged or missing cartilage) in weight-bearing joints—most commonly the knee, but also ankle, hip, and shoulder. The procedure involves creating tiny fractures (microfractures) in the bone beneath the cartilage defect using a sharp awl, which stimulates bone marrow stem cells to migrate into the defect and form fibrocartilage 'scar tissue' to fill the void. While not as durable as native hyaline cartilage (original smooth joint cartilage), fibrocartilage provides reasonable load distribution and pain relief in 70-80% of patients at 2-5 years post-op. Microfracture is best suited for: focal defects less than 2-4 square cm, patients under 40 years, high-activity individuals wanting to avoid or delay joint replacement, acute traumatic cartilage injuries (not degenerative arthritis). Recovery requires strict non-weight-bearing for 6-8 weeks to allow fibrocartilage to form without being crushed, making this a demanding rehab but worthwhile for carefully selected patients wanting joint preservation.
Osgood-Schlatter Disease (Growing Pains in Knee)
Osgood-Schlatter disease causes knee pain and a painful bump below the kneecap in active growing children. Learn about causes, treatment, when your child can return to sport, and whether it goes away.
Osteochondral Allograft Transplantation (Fresh Donor Cartilage)
Transplant of fresh cartilage and bone from deceased donor to repair large cartilage defects - used for massive cartilage damage (more than 6-10 cm²) too large for other repairs, preserves patient's own joint and delays joint replacement by 10-15 years in young active patients
OATS - Mosaicplasty (Transferring Your Own Cartilage Plugs)
Surgical procedure transferring cylindrical plugs of healthy cartilage and bone from non-weight-bearing area of your own knee to fill cartilage defects - for medium-sized defects 1-4 cm², better long-term results than microfracture (75-85% success at 10 years), uses your own normal hyaline cartilage
Knee Cartilage Damage - Osteochondral Defects (Damaged Knee Joint Surface)
Osteochondral defects in knee - damage to both cartilage AND underlying bone causing pain, swelling, catching/locking, and leading to arthritis. Common locations: patellofemoral joint (kneecap cartilage), femoral condyles (weight-bearing surfaces), trochlea (kneecap groove). Causes: acute trauma (patellar dislocation, dashboard injury, ACL injury), osteochondritis dissecans in young athletes, degenerative wear. Symptoms worse than pure cartilage damage (bone component causes bone marrow edema and chronic pain). Treatment: conservative (physiotherapy, activity modification) for small defects, or surgery (microfracture for small, OATS for medium, osteochondral allograft or ACI for large defects). Outcomes depend on size, location, age - patellofemoral defects have worse prognosis than condylar defects.
Osteochondritis Dissecans (OCD) of the Knee in Children
Osteochondritis dissecans (OCD) is a condition where a segment of bone and overlying cartilage in the knee loses blood supply and can separate, creating a loose piece in the joint - it most commonly affects active children and adolescents aged 10-20 years in the thighbone just above the knee joint - juvenile OCD (in children with open growth plates) has better healing potential than adult OCD, with 50-60% healing with conservative treatment (activity restriction, protected weight-bearing for 3-6 months) - unstable or displaced fragments require surgery to drill the bone (stimulate healing) or fix the fragment back in place achieving 70-85% good outcomes.
Bone Cancer in Children and Young Adults (Osteosarcoma)
Osteosarcoma is the most common primary bone cancer in children, adolescents, and young adults (peak age 10-20 years), typically developing in the metaphysis (growing end) of long bones—most commonly around the knee (60-70% of cases: distal femur, proximal tibia) or proximal humerus (upper arm). It presents as progressively worsening bone pain (initially mistaken for growing pains), swelling, and occasionally a palpable mass, often following minor trauma that brings attention to the area. Osteosarcoma is an aggressive malignancy that produces abnormal bone (osteoid) and requires intensive multimodality treatment: neoadjuvant chemotherapy (pre-operative chemotherapy to shrink tumor, 8-12 weeks), limb salvage surgery (removing tumor while preserving limb function with endoprosthesis or allograft reconstruction, 90-95% of cases), and adjuvant chemotherapy (post-operative chemotherapy to kill micrometastases, 6-8 months total). With modern treatment protocols, 5-year survival is 65-70% for localized disease, though metastatic disease at presentation (20% of cases, usually lung) has poorer prognosis (30-40% survival).
Broken Kneecap (Patella Fracture)
Kneecap fractures usually need surgery to restore knee function. Learn about symptoms, surgery with wires or screws, recovery timeline, and when you can walk again.
Kneecap Dislocation in Children and Teens
Patellar instability in children and adolescents occurs when the kneecap (patella) slides out of position, usually to the outside of the knee - it most commonly affects teenage girls during sports involving pivoting or cutting movements - first-time dislocations are typically treated non-surgically with bracing and physiotherapy (60-70% avoid recurrence), while recurrent instability often requires surgery to reconstruct the ligament holding the kneecap in place (MPFL reconstruction) or realign knee structures, achieving 85-90% stability after surgery.
Jumper's Knee (Patellar Tendinitis)
Patellar tendinitis (jumper's knee) is an overuse injury causing pain at the bottom of the kneecap where the patellar tendon attaches, most commonly affecting jumping athletes (basketball, volleyball, netball players) due to repetitive stress during landing and takeoff. The condition develops from accumulated microtrauma to the tendon causing degenerative changes (tendinosis—collagen breakdown and failed healing) rather than acute inflammation, presenting as anterior knee pain that worsens with jumping, running, squatting, or stairs and is tender to touch just below the kneecap. Patellar tendinopathy progresses through stages from pain only after activity (Stage 1) to constant pain affecting sport performance (Stage 3-4), classified by the Blazina system. Treatment focuses on load management and eccentric strengthening exercises (heavy slow resistance training shown to stimulate tendon remodeling), with 70-80% achieving good results over 3-6 months of conservative management, though 10-20% develop chronic symptoms requiring surgical intervention (debridement or tendon scraping) for refractory cases not responding to 6-12 months of physiotherapy.
Patellar Tendon Tear (Complete Rupture)
Patellar tendon rupture is a complete tear of the tendon connecting the kneecap (patella) to the shin bone (tibia), causing sudden severe knee pain, inability to straighten the leg, and loss of the extensor mechanism—a devastating injury that requires emergency surgical repair to restore knee function. These ruptures typically occur during forceful eccentric quadriceps contraction (landing from a jump, sudden deceleration, stumbling down stairs) in adults 30-50 years old, often with predisposing tendon weakening from chronic patellar tendinopathy, corticosteroid use, systemic diseases (diabetes, chronic kidney disease, rheumatoid arthritis), or prior knee surgery. Clinically, patients present with inability to lift the leg straight (positive straight leg raise test), palpable gap below the kneecap, high-riding patella on X-ray (patella alta), and large hemarthrosis (blood in joint). Treatment is almost always surgical—early repair within 2 weeks critical as delayed surgery has worse outcomes due to tendon retraction, muscle shortening, and scar tissue formation. Surgical repair involves reattaching torn tendon to patella with strong sutures, augmentation with wire or suture anchors, and often requiring tissue augmentation in chronic cases (allograft, synthetic graft, hamstring autograft). Recovery timeline: 4-6 months to regain full knee function, 6-12 months to return to high-level activities, with 75-85% achieving good functional outcomes if repaired early, though many have residual quadriceps weakness (10-20% weaker than uninjured leg).
Kneecap Instability (Patellar Dislocation)
Patellofemoral instability is a condition where the kneecap (patella) is prone to slipping out of place (dislocating) to the outside of the knee, most commonly affecting adolescents and young adults (particularly teenage females) during pivoting or cutting activities. The first dislocation typically occurs during sports (netball, basketball, football, dance) when changing direction suddenly, causing immediate severe pain, visible deformity (kneecap displaced to outside of knee), and inability to straighten the leg—though kneecap usually reduces spontaneously or with gentle straightening. Patellofemoral instability results from combination of anatomical risk factors (shallow trochlear groove—shallow femoral groove kneecap sits in, high-riding kneecap—patella alta, increased Q-angle causing lateral pull, ligamentous laxity) and soft tissue injury to the medial patellofemoral ligament (MPFL—main restraint preventing lateral dislocation) which tears during dislocation. After first-time dislocation, recurrence risk is 15-44% overall but up to 60% in high-risk patients with anatomical abnormalities. Treatment after first dislocation: conservative management (immobilization 2-4 weeks, physiotherapy for quadriceps strengthening and VMO retraining) appropriate for 60-70% who don't have recurrent instability, versus surgical stabilization (MPFL reconstruction, tibial tubercle osteotomy, trochleoplasty) reserved for recurrent dislocators or those with major anatomical risk factors. Surgical outcomes: 85-90% success preventing recurrent dislocation after MPFL reconstruction in appropriately selected patients.
Posterior Cruciate Ligament (PCL) Tear
Posterior cruciate ligament (PCL) injuries are tears of the thick ligament running through the center of the knee that prevents the shin bone (tibia) from sliding backward relative to the thigh bone (femur), most commonly occurring from dashboard injuries in motor vehicle accidents, falls onto a flexed knee, or hyperextension injuries in sports. Unlike ACL tears which cause dramatic instability, isolated PCL injuries often cause surprisingly mild symptoms—vague knee discomfort, difficulty with stairs or kneeling, and subtle posterior sag when examined—making them frequently missed or underdiagnosed. PCL tears are graded I-III based on severity (Grade I: partial tear with less than 5mm posterior translation, Grade II: complete tear with 5-10mm translation, Grade III: complete tear with more than 10mm translation often with associated injuries). Isolated PCL injuries (60-70% of cases) are usually managed conservatively with quadriceps-focused physiotherapy achieving 70-80% satisfactory outcomes, as the quadriceps muscle compensates for PCL insufficiency by pulling tibia forward during weight-bearing. However, combined PCL injuries with posterolateral corner (PLC), ACL, or multi-ligament knee injuries require surgical reconstruction to prevent chronic instability and arthritis. PCL reconstruction surgery is technically demanding (done arthroscopically using hamstring or Achilles allograft), with 75-85% achieving good stability but residual mild laxity common, and return to high-level sports taking 9-12 months with many athletes not returning to pre-injury performance level.
Inner Knee Pain (Pes Anserine Bursitis)
Pes anserine bursitis is inflammation of the bursa (fluid-filled sac that reduces friction) located on the inner side of the knee about 5-7cm below the joint line, where three hamstring tendons (sartorius, gracilis, semitendinosus—collectively called pes anserinus meaning 'goose's foot' for their fan-like arrangement) attach to the shin bone (tibia), most commonly affecting middle-aged and older women (particularly those with obesity, osteoarthritis, or diabetes) and distance runners. The condition presents as localized tenderness and pain on the inside of the knee that worsens with stairs, prolonged sitting, or getting up from a chair, often mimicking medial meniscus tears or medial compartment arthritis but distinguished by point tenderness 5-7cm below the joint line (not at the joint line itself). Pes anserine bursitis develops from repetitive friction between the tendons and underlying bursa, exacerbated by knee valgus (knock-knee) alignment, hamstring tightness, or biomechanical overload from obesity or altered gait patterns. Diagnosis is clinical (point tenderness at pes anserine insertion site) with imaging rarely needed unless excluding other pathology. Treatment is almost always conservative: activity modification, ice, NSAIDs, physiotherapy for hamstring stretching and strengthening, addressing underlying biomechanics (orthotics, weight loss), with 80-90% achieving resolution in 4-8 weeks. Corticosteroid injections provide rapid relief if conservative management fails (85-90% success rate), with surgery rarely needed (excision of bursa only if chronic refractory cases not responding to 6-12 months of conservative treatment and injections).
Posterolateral Corner Injuries (PLC - Outer Knee Ligaments)
Outer knee stabilizers (LCL, popliteus, popliteofibular ligament) torn from high-energy trauma - dial test diagnostic, nearly always combined with ACL/PCL tears, missed injury causes ACL graft failure 30-50%
Knee Growth Plate Injuries in Children (Proximal Tibia)
Proximal tibial physeal injuries are fractures through the growth plate at the top of the shin bone just below the knee in children and adolescents - these are rare but serious injuries (risk of blood vessel damage and leg growth disturbance) typically caused by high-energy trauma like motor vehicle accidents or sports collisions, requiring urgent assessment for arterial injury and usually needing surgical fixation to prevent growth deformity.
Proximal Fibula Dislocation (Knee Joint)
Proximal tibiofibular joint dislocation is a rare injury where the small fibula bone at the outer knee pops out of its joint with the tibia (shin bone), typically from sports trauma or falls causing twisting force - it causes lateral knee pain, visible bump below knee, and occasionally foot drop from nerve injury, with treatment ranging from closed reduction and immobilization (most cases healing well in 4-6 weeks) to surgical fixation for unstable or recurrent dislocations.
Segond Fracture (Knee Bone Chip with ACL Tear)
A Segond fracture is a small chip of bone pulled off the outer edge of the tibia (shin bone) near the knee joint, occurring when the anterolateral ligament tears during a twisting knee injury - this tiny fracture fragment is a 'red flag' sign that nearly always (95-100%) indicates a serious ACL (anterior cruciate ligament) tear, with treatment focused on reconstructing the torn ACL rather than fixing the small bone chip which heals on its own.
Septic Arthritis (Joint Infection in Adults)
Septic arthritis is a bacterial infection inside a joint causing severe pain, swelling, fever, and inability to move the joint - it's a medical emergency requiring urgent treatment within 6-12 hours to prevent permanent cartilage destruction, with treatment involving emergency surgical drainage and 4-6 weeks of IV antibiotics achieving 70-80% good outcomes if treated promptly, but 25-50% develop permanent joint damage if treatment delayed more than 24 hours.
Septic Arthritis (Infected Joint - Medical Emergency)
Bacterial joint infection requiring urgent drainage and antibiotics within 24-48 hours - delays cause irreversible cartilage destruction, secondary arthritis in 30-50%
Sinding-Larsen-Johansson Syndrome (Kneecap Growth Plate Pain)
Sinding-Larsen-Johansson syndrome is a growth-related overuse condition affecting the bottom of the kneecap (patella) in active adolescents aged 10-14 years - it causes localized pain and tenderness at the inferior pole of the patella from repetitive jumping and running activities causing inflammation where the patellar tendon attaches to the growing kneecap, typically resolving completely with activity modification and physiotherapy within 3-6 months as the growth plate matures.
Bowlegs (Blount's Disease / Tibia Vara)
Tibia vara (Blount's disease) is abnormal bowing of the lower legs caused by growth disturbance in the inner (medial) part of the shin bone's growth plate near the knee - differs from normal physiologic bowing in toddlers by being progressive, asymmetric, and not self-correcting - infantile form (develops before age 3) most common in obese early walkers, often responds to bracing if caught early but may require surgery to correct severe deformity - adolescent form (age 8-15) almost always requires corrective osteotomy surgery (cutting and realigning bone) as bracing ineffective - untreated leads to progressive bowleg deformity, knee arthritis, and walking difficulties
Upper Back
Adolescent Scoliosis (Curved Spine)
Adolescent idiopathic scoliosis causes sideways curvature of the spine during growth. Learn about school screening, bracing, when surgery is needed, and what to expect with treatment.
Curved Spine in Young Children (Early Onset Scoliosis)
Early onset scoliosis is sideways curvature of the spine developing before age 10 (typically ages 0-5), different from teenage scoliosis because it occurs during critical lung and spine growth - EOS causes visible spine deformity, uneven shoulders or hips, and can restrict lung development if severe - causes include congenital spine abnormalities, neuromuscular conditions (cerebral palsy), or idiopathic (unknown) - treatment ranges from observation and bracing for mild curves to growth-friendly surgery for severe curves, with goal of controlling curve while allowing continued spine and chest growth
Ankle
Ankle Arthritis
Ankle arthritis causes pain and stiffness in your ankle joint. Learn about symptoms, treatment options from braces to ankle fusion or replacement, and how to manage ankle pain effectively.
Ankle Fusion (Arthrodesis)
Ankle fusion permanently joins ankle bones to eliminate painful arthritic joint - gold standard for end-stage ankle arthritis, 90-95% pain relief, 85-90% fusion rate, but eliminates ankle motion and increases stress on adjacent joints
Total Ankle Replacement
Total ankle replacement preserves ankle motion for end-stage arthritis - modern implants show 75-85% survival at 10 years, allows more normal gait than fusion, but higher revision rate and activity restrictions compared to ankle arthrodesis
Ankle Dislocations (Emergency)
Ankle dislocation is orthopedic EMERGENCY requiring urgent reduction within 6 hours - 98% associated with fractures, skin necrosis risk within 4-6 hours, neurovascular injury 10-20%, requires immediate reduction then definitive fracture fixation
Broken Ankle
An ankle fracture (broken ankle) is a break in one or more of the bones that make up your ankle joint. Learn about symptoms, treatment options including surgery, recovery timelines, and when you can return to normal activities.
Calcaneal Tuberosity Fractures (Achilles Avulsion)
Achilles tendon avulsion fracture pulling bone fragment off back of heel - causes inability to push off or stand on toes, nearly always requires surgical repair with tension band wiring or screw fixation
Midfoot Fracture-Dislocations (Chopart Injuries)
Chopart injuries are severe midfoot fracture-dislocations where the bones of your midfoot separate from the ankle bones at two key joints, usually from high-energy trauma like car accidents or falls—these injuries cause severe pain, swelling, and inability to walk, almost always require surgery to realign and stabilize the bones with plates and screws, and typically need 3-6 months of non-weight bearing recovery followed by gradual rehabilitation, with arthritis and stiffness being common long-term complications affecting 50-70% of patients.
Chronic Ankle Instability (Recurring Ankle Sprains)
Chronic ankle instability is a condition where your ankle repeatedly 'gives way' or feels unstable, usually developing after one or more severe ankle sprains that didn't heal properly—you may experience your ankle rolling outward frequently (especially on uneven surfaces), swelling and pain after activities, and a constant feeling that your ankle might give out. Most cases improve with 3-6 months of physiotherapy focused on ankle strengthening and balance exercises, but if instability persists despite therapy, surgical ligament reconstruction using your own tissues provides 85-90% success in restoring ankle stability, with most patients returning to sports within 4-6 months after surgery.
High Ankle Sprains (Syndesmotic Injuries)
High ankle sprains (syndesmotic injuries) are tears of the ligaments connecting the tibia and fibula bones above the ankle joint, occurring from external rotation injuries when the foot is planted and the body rotates outward - they account for 10-15% of ankle sprains but are more severe than typical lateral ankle sprains, causing pain above the ankle with walking and weight-bearing, taking 3-6 months to heal versus 4-6 weeks for lateral ankle sprains - treatment depends on stability: stable injuries heal with CAM boot immobilization and protected weight-bearing for 4-6 weeks, while unstable injuries (widening of the tibiofibular joint on weight-bearing X-rays) require surgery with syndesmotic screw or suture button fixation to restore ankle stability.
Ankle Sprains (Rolled Ankle)
Ankle sprains (rolling your ankle) are the most common sports injury, occurring when you roll your foot inward causing the outer (lateral) ankle ligaments to stretch or tear - most ankle sprains are mild (Grade 1 stretching) or moderate (Grade 2 partial tear) healing fully in 2-6 weeks with RICE treatment (rest, ice, compression, elevation) and physiotherapy, though 10-20% develop chronic ankle instability (repeated sprains, giving way) requiring ligament reconstruction surgery if physiotherapy fails
Inside Ankle Sprain (Deltoid Ligament Injury)
Medial ankle sprains are injuries to the deltoid ligament—a strong, fan-shaped ligament complex on the inside (medial) side of the ankle connecting the tibia (shin bone) to the talus and calcaneus (ankle bones)—much less common than lateral (outside) ankle sprains, accounting for only 5-10% of all ankle sprains. These injuries typically occur from eversion (ankle rolling outward) or rotational forces, often associated with high-energy trauma (sports injuries, falls) or ankle fractures (deltoid injury with fibula fracture is bimalleolar equivalent fracture requiring surgery). Isolated deltoid sprains present with inside ankle pain, swelling, and difficulty bearing weight. Most heal with conservative treatment (boot immobilization, physiotherapy) over 6-8 weeks, though severe injuries may require surgery. The deltoid ligament is stronger than lateral ankle ligaments, so medial ankle pain after injury should prompt careful evaluation to rule out fractures or syndesmosis injuries often associated with deltoid tears.
Peroneal Tendon Tears (Outside Ankle Tendons)
Peroneal tendon injuries involve tears, splits, or subluxation (dislocation) of the two tendons (peroneus longus and brevis) running behind the outside ankle bone (lateral malleolus), which evert the foot (turn sole outward) and stabilize the ankle, most commonly affecting athletes in cutting sports, dancers, and individuals with high-arched (cavus) feet or chronic ankle instability. These injuries range from peroneal tendinitis (inflammation from overuse—20-30% of lateral ankle pain in runners), to longitudinal splits within tendons (peroneus brevis most commonly affected—tears along length of tendon), to complete ruptures, and peroneal subluxation/dislocation (tendons slip out from behind ankle bone during movement due to torn retinaculum—restraining band holding tendons in groove). Patients present with lateral ankle pain, swelling behind outer ankle bone, clicking or snapping sensation (if subluxing), and weakness with foot eversion. Diagnosis requires high clinical suspicion as often misdiagnosed as lateral ankle sprain, with ultrasound or MRI confirming tendon tears, splits, or subluxation. Treatment depends on injury pattern: acute tendinitis managed conservatively with immobilization, physiotherapy, and NSAIDs (70-80% success); chronic tendinosis or partial splits may need 3-4 months conservative management before considering surgery; complete ruptures, large longitudinal splits, and recurrent subluxation typically require surgical repair (debridement of diseased tissue, tubularization of split tendons, groove deepening for subluxation). Surgical outcomes: 75-85% good-to-excellent results with tendon repair/reconstruction, though return to high-level sports takes 6-9 months and recurrence of subluxation occurs in 5-15% despite surgery.
Adult Flatfoot (Posterior Tibial Tendon Dysfunction)
Posterior tibial tendon dysfunction (PTTD) is progressive weakening and degeneration of the posterior tibial tendon—the main tendon supporting the arch of the foot—leading to adult-acquired flatfoot deformity, most commonly affecting middle-aged and older women (particularly those with obesity, diabetes, or hypertension). The condition develops when the posterior tibial tendon (running behind inside ankle bone down to midfoot bones) gradually stretches, tears, and fails, causing the foot arch to collapse, the heel to tilt outward (valgus), and the forefoot to turn outward (abduction)—creating a characteristic 'too many toes' sign when viewing foot from behind. PTTD progresses through four stages: Stage I (tendinitis with pain but no deformity), Stage II (flexible flatfoot deformity that can be passively corrected), Stage III (fixed rigid flatfoot that cannot be corrected), and Stage IV (ankle arthritis from altered biomechanics). Patients present with progressive medial ankle and arch pain, difficulty walking on uneven ground, inability to stand on tiptoes on affected foot (single heel raise test), and worsening foot shape over months to years. Treatment is stage-dependent: Stage I managed conservatively with immobilization, orthotics, physiotherapy (80-90% success); Stage II requires orthotic trial but often needs surgical tendon reconstruction and bone realignment procedures (85-90% success with surgery); Stages III-IV require major reconstructive surgery (joint fusions) with 70-80% achieving stable, functional (though stiff) foot. Untreated PTTD progresses inexorably to severe fixed deformity, chronic pain, and disability.
Rigid Flatfoot (Pes Planus)
Rigid flatfoot is a condition where the foot arch remains flat and doesn't restore when standing on tiptoes (unlike flexible flatfoot), most commonly caused by tarsal coalition (abnormal bone or cartilage connection between foot bones) in children ages 8-15, leading to painful flat feet, ankle stiffness, and difficulty with sports - treatment ranges from orthotics and activity modification (60-70% improve) to surgical removal of the coalition or fusion if conservative treatment fails.
pelvis
Pelvic Ring Injuries (Open Book Fractures)
Anteroposterior compression (APC) pelvic injuries, commonly called 'open book' fractures, occur when a front-to-back crushing force causes the pelvis to spring open like a book—most often from high-energy trauma such as car accidents (side-impact or head-on collisions) or pedestrian strikes, with injury severity ranging from mild pubic symphysis widening (APC I) to complete disruption of the pelvic ring with life-threatening bleeding from torn pelvic veins and arteries (APC III requiring emergency stabilization). In Australia, major trauma centres manage these injuries with immediate resuscitation, temporary external fixation or pelvic binders to control hemorrhage, followed by definitive surgical fixation once the patient is stable—recovery typically takes 3-6 months for walking and 6-12 months for return to normal activities, with outcomes depending on associated injuries to bladder, urethra, nerves, and blood vessels that occur in up to 40-60% of severe cases.
Pubic Rami Fractures
Comprehensive patient guide to pubic rami fractures in elderly patients - fragility fractures, isolated vs pelvic ring injuries, non-operative management, and recovery timeline
Head & Neck
Athletic Groin Pain (Sports Hernia/Athletic Pubalgia)
Comprehensive guide to athletic groin pain - Doha classification, adductor-related groin pain, pubic symphysis dysfunction, FAI differential, Copenhagen protocol, and surgical treatment for orthopaedic exam
Atlantoaxial Instability
Comprehensive guide to atlantoaxial instability - C1-C2 pathology, Down syndrome association, ADI measurement, surgical stabilization and fusion techniques for orthopaedic exam
Autologous Chondrocyte Implantation (ACI)
Comprehensive guide to autologous chondrocyte implantation and MACI - two-stage cartilage repair, indications, surgical technique, and outcomes for orthopaedic examination
Avascular Necrosis of the Humeral Head
Comprehensive guide to causes, staging, and treatment of humeral head AVN including core decompression, biological treatments, and joint replacement surgery decision-making
Calcific Tendinitis of the Shoulder (Calcium Deposits in Rotator Cuff)
Calcium deposits form in rotator cuff tendons causing severe shoulder pain. Affects 3% of adults, peak age 30-50. Most common in supraspinatus tendon. Resorptive phase causes excruciating pain (8-10/10). Often self-limiting over months to years. Treatment includes NSAIDs, barbotage (needle aspiration of calcium), ESWT, corticosteroid injections, or arthroscopic removal if conservative measures fail.
DDH Treatment Options (Developmental Dysplasia of the Hip in Babies and Children)
Developmental dysplasia of the hip (DDH) - spectrum from unstable hip to dislocated hip in babies and children. Affects 1-3% of newborns, girls 4-6x more than boys. Universal newborn screening in Australia. Treatment age-dependent: Pavlik harness 0-6 months (95% success), closed reduction and spica cast 6-18 months, open reduction and pelvic osteotomy 18 months-8 years. Early detection and treatment prevents lifelong hip problems and early arthritis.
Iliac Wing Fracture (Duverney Fracture - Broken Pelvic Bone)
Iliac wing fracture (Duverney fracture) - break in wing of pelvic bone from direct trauma. Usually stable injury from motor vehicle side-impact collision, fall from height, or pedestrian struck by vehicle. Most treated non-operatively with pain management and early mobilization. Good prognosis for isolated fractures. Must assess for associated injuries (intra-abdominal bleeding, bladder rupture, other fractures). Recovery 6-12 weeks.
Intertrochanteric Hip Fracture (Broken Hip Between Trochanters)
Hip fracture in elderly between greater and lesser trochanter. Second most common hip fracture after femoral neck fractures. Average age 75-80. Caused by low-energy falls. Requires urgent surgery within 24-48 hours (dynamic hip screw or intramedullary nail). Good bone healing but high 1-year mortality 20-30% due to medical complications. Weight-bearing immediately after surgery. Orthogeriatric co-management improves outcomes.
Forearm
Broken Forearm (Both Bones)
A both-bone forearm fracture means both the radius and ulna (the two bones in your forearm) are broken. Learn about treatment in children versus adults, surgery with plates, casting, and recovery.
Broken Wrist (Distal Radius Fracture)
A distal radius fracture is a break in the wrist bone near your hand - the most common broken bone in adults. Learn about treatment options, recovery time, and what to expect from a broken wrist.
Wrist Arthritis (Pinky Side of Wrist)
DRUJ arthritis is wear-and-tear or post-injury arthritis affecting the joint where the two forearm bones meet at the wrist (on the pinky side) - this joint allows you to rotate your forearm (turn palm up and down) - arthritis here causes pain on the pinky side of the wrist, difficulty turning doorknobs or using screwdrivers, clicking or grinding with forearm rotation, and swelling - treatment ranges from splints and anti-inflammatory medication to surgery (joint replacement or salvage procedures), with 70-80% achieving good pain relief and functional improvement
Broken Forearm in Children (Both-Bone Forearm Fracture)
Forearm fractures are one of the most common broken bones in children (affecting 1 in 25 kids before age 16), usually from falling on an outstretched hand or direct blow during sports or play—causing immediate pain, visible deformity, and inability to move the arm. Most heal excellently with casting alone (4-6 weeks in cast, back to normal activities at 8-10 weeks) because children's bones heal faster than adults and have amazing ability to straighten out crooked healing naturally as the child grows, though some severely displaced or unstable fractures need surgery to realign bones with flexible rods or plates.
Broken Forearm in Adults (Both-Bone Forearm Fracture)
Adult forearm shaft fractures are serious injuries where both forearm bones (radius and ulna) break along their length, usually from high-energy trauma like motor vehicle accidents, falls from height, or direct blows—causing severe pain, visible deformity, and inability to rotate the forearm. Unlike children's forearm fractures which heal well in casts, adult forearm fractures almost always require surgery with plates and screws on both bones (casting alone has 50-60% failure rate with malunion or nonunion) followed by 3-6 months recovery including physiotherapy to regain forearm rotation and strength.
Broken Ulna Bone from Direct Blow (Nightstick Fracture)
An isolated ulna fracture, commonly called a nightstick fracture, is a break in the ulna (inner forearm bone) without injury to the radius (outer forearm bone), typically from direct blow to forearm when raising arm to block a strike—causing localized forearm pain, swelling, and difficulty rotating forearm. Unlike both-bone forearm fractures which require surgery, isolated ulna fractures can often be treated non-surgically with casting if minimally displaced (less than 50% displaced or less than 10 degrees angulated), healing in 8-12 weeks with 85-90% good outcomes. Significantly displaced fractures require surgery (plate and screws) because malunion causes permanent loss of forearm rotation and chronic pain affecting daily activities.
Wrist Cartilage Tears (TFCC Injuries)
TFCC (triangular fibrocartilage complex) injuries are tears in the cartilage cushion on the small-finger side of the wrist that stabilizes the joint and absorbs impact - commonly occurs from falling on outstretched hand, wrist twist injuries, or degenerative wear-and-tear in people over 40 - causes ulnar-sided (pinky-side) wrist pain with gripping, twisting motions, or weight-bearing through the wrist - many cases heal with 4-6 weeks of splinting and physiotherapy, though chronic tears or unstable injuries may require arthroscopic surgery to repair or debride the torn cartilage, with recovery taking 3-6 months to regain full strength and return to activities
Upper Arm
Wrist
Carpal Tunnel Syndrome
Carpal tunnel syndrome causes numbness, tingling, and pain in your hand and fingers. It happens when pressure builds up on the nerve in your wrist. Learn about symptoms, treatments, and when surgery might help.
Ganglion Cysts (Wrist and Hand Lumps)
Ganglion cysts are benign fluid-filled lumps that develop near joints or tendons, most commonly on the back of the wrist (60-70% of cases) or palm side of the wrist near the radial artery (20%) - they contain thick jelly-like fluid from the joint lining and cause a visible bump that may be painless or cause aching with wrist motion - ganglion cysts are completely harmless (not cancer) and resolve spontaneously without treatment in 40-60% of cases over several years, though symptomatic cysts can be treated with aspiration (draining with needle - 30-50% recurrence) or surgical excision (10-20% recurrence).
Broken Hamate Bone (Wrist Fracture in Athletes)
Hamate fractures are breaks in a small wrist bone (hamate) with a prominent hook projection, most commonly occurring as hook of hamate fractures in baseball batters, golfers, and racquet sport players from repetitive trauma when bat or club strikes the palm—causing ulnar-sided wrist pain, weak grip, and often misdiagnosed as wrist sprain for weeks or months. Standard X-rays frequently miss these fractures, requiring CT scan for diagnosis. Treatment options include casting (which has 50-60% failure rate due to poor blood supply to hook) or surgical removal of the broken hook piece (excision arthroplasty), which relieves pain immediately and doesn't affect wrist function, making it the preferred treatment for most athletes.
Kienböck's Disease (Lunate Avascular Necrosis)
Kienböck's disease is avascular necrosis (bone death from loss of blood supply) of the lunate, one of eight small carpal bones in the wrist - it typically affects young adults aged 20-40 years, especially manual laborers, causing progressive wrist pain, stiffness, and weakness over months to years - the lunate bone gradually collapses causing wrist arthritis if untreated - treatment depends on Lichtman staging (I-IV): early stages (I-II) may respond to immobilization or joint-leveling procedures (radial shortening or ulnar lengthening osteotomy) unloading the lunate and allowing revascularization in 50-60% of cases, while advanced stages (III-IV) with lunate collapse and arthritis require salvage procedures (proximal row carpectomy or wrist fusion) sacrificing wrist motion for pain relief.
Psoriatic Arthritis in the Hand
Psoriatic arthritis affecting the hands causes painful swollen joints (especially finger joints), sausage-like swelling of entire digits (dactylitis), nail pitting and changes, and joint destruction in about 30% of people with skin psoriasis - unlike rheumatoid arthritis which affects knuckles symmetrically, psoriatic arthritis often affects the finger tip joints (DIP joints) asymmetrically and can cause severe deformities if untreated, requiring early treatment with disease-modifying medications to prevent permanent joint damage.
Scaphoid Fracture Surgery
Scaphoid fractures are breaks in a small boat-shaped bone in your wrist near the base of your thumb - they commonly occur from falling onto an outstretched hand and are tricky because they often don't show up on initial X-rays and have poor blood supply - most scaphoid fractures heal in a cast over 8-12 weeks, but surgery with a small screw is needed for displaced fractures (moved out of position), fractures not healing in a cast, or fractures in athletes who need faster return to sport
Scaphoid Fractures (Wrist Fracture)
Scaphoid fractures are breaks in a small boat-shaped bone in the wrist near the base of the thumb, commonly caused by falling onto an outstretched hand - they're tricky because they often don't show on initial X-rays and have poor blood supply making them slow to heal, with treatment ranging from cast immobilization for 8-12 weeks to surgical screw fixation for displaced fractures or non-healing cases.
Scaphoid Nonunion (Non-Healing Wrist Fracture)
Scaphoid nonunion occurs when a scaphoid wrist fracture fails to heal after 3-4 months of treatment, affecting 5-10% of scaphoid fractures - it causes persistent wrist pain, weakness, and leads to early wrist arthritis within 5-10 years if untreated, requiring surgical bone grafting and screw fixation with 80-90% success rate in achieving healing and preventing arthritis progression.
Thumb Base Fractures (Bennett and Rolando Fractures)
Thumb base fractures (Bennett and Rolando fractures) are breaks at the bottom of the thumb metacarpal bone where it forms the critical saddle joint with the wrist - Bennett fractures (most common) are diagonal breaks involving the joint surface with a small fragment held in place by ligament while main bone fragment is pulled out of position by thumb muscle, typically from punching or fall onto bent thumb - because the fracture disrupts the thumb joint and is unstable, most require surgery with pins or screws to restore alignment and prevent long-term arthritis - recovery takes 6-12 weeks in a cast/splint with gradual return to full strength over 3-4 months
Ulnar-Sided Wrist Pain (Ulnar Impaction Syndrome)
Ulnar impaction syndrome occurs when the ulna bone (forearm bone on pinky side) is too long relative to the radius bone, causing excessive pressure on the ulnar side of the wrist - this leads to pain on the pinky side of the wrist, worse with gripping, twisting, and leaning on the hand - the extra-long ulna damages the triangular fibrocartilage (TFCC) and wrist cartilage over time - conservative treatment (activity modification, wrist splinting, corticosteroid injections) provides temporary relief in 30-50% of patients, while persistent symptoms are treated with surgery to shorten the ulna bone (ulnar shortening osteotomy) achieving 80-85% good outcomes.
Lower Back
Broken Tailbone (Coccyx Fracture)
A broken tailbone (coccyx fracture) causes severe pain when sitting. Learn about causes, how long it takes to heal, treatment options including cushions and injections, and when surgery might be needed.
Sacral Fractures (Tailbone Area Fracture)
Sacral fractures are breaks in the large triangular bone at the base of the spine (sacrum) connecting the spine to the pelvis, typically caused by high-energy trauma (car accidents, falls from height) or low-energy falls in elderly osteoporotic patients - they cause severe lower back and buttock pain, difficulty sitting or walking, and may involve nerve damage causing leg weakness or bowel/bladder problems requiring urgent treatment.
Elbow
Coronoid Fracture (Elbow Bone Break)
A coronoid fracture is a break of the coronoid process at the front of the elbow. Learn about causes, the terrible triad injury, surgery with plates or screws, and recovery from this elbow injury.
Cubital Tunnel Syndrome (Ulnar Nerve Compression at Elbow)
Cubital tunnel syndrome is compression of the ulnar nerve as it passes behind the inner elbow bone (medial epicondyle) in the cubital tunnel - it is the second most common nerve compression syndrome after carpal tunnel, causing numbness and tingling in the ring and small fingers, hand weakness, and clumsiness with fine motor tasks - symptoms typically worsen with prolonged elbow flexion (talking on phone, sleeping with bent elbow) and improve with conservative treatment (night splinting, avoiding pressure on elbow) in 50-60% of mild cases, while moderate-severe cases often require surgery which achieves 80-90% improvement if performed before permanent nerve damage occurs.
Biceps Tendon Tear at the Elbow
A distal biceps rupture occurs when the biceps tendon tears completely off the bone at your elbow, usually from sudden forceful straightening while lifting something heavy—you'll feel a sharp pop in the front of your elbow with immediate pain, bruising, and a visible bulge in your upper arm where the biceps muscle bunches up. Most active people choose surgical reattachment within 2-4 weeks for best results (restoring 95% of strength), while non-surgical treatment leaves permanent 30-40% loss of arm twisting strength and endurance, making surgery the preferred option for people under 60 who want full arm function.
Elbow Arthritis (Worn Elbow Joint)
Elbow arthritis causes pain and stiffness from worn cartilage. Learn about post-traumatic arthritis, rheumatoid arthritis, treatment options, cortisone injections, and when elbow replacement might help.
Dislocated Elbow
An elbow dislocation occurs when the bones of your forearm separate from your upper arm bone. Learn about simple versus complex dislocations, treatment, and recovery expectations.
Broken Outside Elbow Bone in Children (Lateral Condyle Fracture)
Lateral condyle fractures are breaks in the outside knob of the elbow bone (humerus) in children, the second most common pediatric elbow fracture after supracondylar fractures, typically from fall onto outstretched arm causing elbow to buckle inward—presenting with outside elbow pain, swelling, and difficulty straightening arm. These fractures are tricky because they involve the growth plate and joint surface, with high risk of nonunion (failure to heal) or malunion (crooked healing) causing permanent elbow deformity if undertreated. Minimally displaced fractures (less than 2mm) can be treated with casting, but any displacement greater than 2mm requires surgery (pins or screws) to prevent complications, with 85-90% excellent outcomes when treated appropriately but 30-40% complication rate if treatment inadequate.
Tennis Elbow (Lateral Epicondylitis)
Tennis elbow causes pain on the outer elbow from overuse. Learn about physiotherapy, braces, injections, and surgery options. Most people recover without surgery.
Golfer's Elbow (Medial Epicondylitis)
Golfer's elbow causes pain on the inner elbow from overuse. Learn about physiotherapy, injections, when to check for nerve problems, and treatment options.
Olecranon Fractures (Elbow Point Fracture)
Fracture of elbow point bone from direct fall - nearly always requires tension band wiring or plate fixation surgery to restore triceps function and elbow extension
Pronator Syndrome (Median Nerve Compression at Elbow)
Pronator syndrome is compression of the median nerve in the upper forearm near the elbow, causing forearm pain, thumb/index/middle finger numbness, and hand weakness that mimics carpal tunnel syndrome but with key differences—pain worsens with repetitive gripping and forearm pronation (rotating palm down), and symptoms extend to the forearm and palm unlike carpal tunnel which spares the palm and causes nocturnal symptoms. The median nerve can be compressed at four potential sites in the proximal forearm: ligament of Struthers (uncommon bony abnormality 1cm above elbow), lacertus fibrosus (fascial band from biceps tendon), between the two heads of pronator teres muscle (most common site 60-70%), or beneath the fibrous arch of flexor digitorum superficialis (FDS). Diagnosis is clinical with provocative tests (resisted pronation reproducing symptoms, tenderness over pronator teres) and nerve conduction studies showing focal slowing. Treatment is initially conservative with activity modification, NSAIDs, splinting, and physiotherapy achieving success in 50-70% of mild cases, while surgical decompression (releasing all four potential compression sites) is reserved for failed conservative treatment or severe cases with motor weakness, achieving 80-85% good-excellent outcomes with 3-6 month recovery.
Radial Head Dislocations (Elbow Dislocation in Children)
Radial head dislocations occur when the radial bone at the elbow slips out of position, most commonly seen as 'nursemaid's elbow' in young children (ages 1-4) when the arm is pulled suddenly, causing immediate pain and refusal to use the arm - treatment involves a quick reduction maneuver that provides instant relief in 90-95% of cases, though some dislocations are associated with forearm fractures (Monteggia injury) requiring surgery.
Radial Head Fracture (Elbow Fracture)
A radial head fracture is a break in the knobby top of the radius bone at the elbow. Usually caused by falling on an outstretched hand, most heal without surgery but some complex fractures need repair or replacement.
Radial Neck Fractures in Children (Elbow Fracture)
Radial neck fractures are breaks just below the radial head bone at the elbow in children ages 4-10, typically caused by falling onto an outstretched hand, resulting in elbow pain, swelling, and difficulty straightening the arm - most minimally angulated fractures (less than 30 degrees tilt) heal well with casting alone in 4-6 weeks, while severely tilted fractures may require manipulation or surgery to prevent permanent elbow stiffness.
Radial Tunnel Syndrome (Forearm Nerve Compression)
Radial tunnel syndrome is compression of the radial nerve in the forearm causing deep aching pain on the outer (thumb) side of the forearm and elbow, often mimicking tennis elbow but without weakness - it results from repetitive gripping or twisting activities and typically improves with 3-6 months of rest, activity modification, and physiotherapy, though 10-20% of cases may require surgical nerve decompression if conservative treatment fails.
Hand
Deep Hand Infections (Space Infections)
Deep space hand infections are serious bacterial infections in the closed compartments deep within your hand, usually from puncture wounds, bites, or spread from finger infections—they cause severe pain, swelling, inability to move fingers, and require emergency surgical drainage in the operating theatre plus IV antibiotics to prevent permanent hand damage, with most patients hospitalized for 3-7 days and needing 4-8 weeks of hand therapy recovery.
Dupuytren's Contracture
Dupuytren's contracture causes fingers to bend into the palm and not straighten. Learn about this progressive hand condition, when to consider treatment, and options from needle release to surgery.
Extensor Tendon Injuries (Hand & Finger)
Extensor tendon injuries occur when the tendons on the back of your hand or fingers that straighten your fingers are cut or torn—commonly from lacerations, crush injuries, or jamming injuries—causing inability to straighten the affected finger. Treatment depends on location: simple cuts over knuckles can be splinted for 6 weeks with 90% success, but injuries at the fingertip (mallet finger) or middle joint (boutonniere) often leave permanent stiffness even with treatment, and deep cuts usually require surgical repair followed by 8-12 weeks of hand therapy.
Dislocated Finger (Jammed Finger)
A dislocated finger happens when a finger joint pops out of place. Learn about PIP and DIP dislocations, buddy taping, when surgery is needed, and recovery timeline.
Cut Flexor Tendon (Hand/Finger Tendon Injury)
A cut flexor tendon prevents you from bending your fingers. Learn about emergency treatment, tendon repair surgery, Zone 2 'no man's land' injury, hand therapy protocol, and recovery.
Finger Tendon Sheath Infection (Flexor Tenosynovitis)
Flexor tenosynovitis is a serious bacterial infection inside the protective sheath surrounding the flexor tendons in your finger (the tendons that bend your finger)—usually from puncture wounds, bites, or spread from nail infections—causing severe throbbing pain, swelling of the entire finger like a sausage, inability to straighten the finger due to pain, and requires emergency surgery within 24 hours to drain the infection and save the tendon, as delays can cause permanent tendon death and finger stiffness even with treatment.
Skier's Thumb (Gamekeeper's Thumb)
Gamekeeper's thumb, more commonly called skier's thumb, is a tear or rupture of the ulnar collateral ligament on the inner side of your thumb base, usually from falling onto an outstretched thumb (classic skiing injury when thumb gets caught in pole strap) or ball forcefully bending thumb outward—causing immediate pain, swelling, and weak pinch grip. Partial tears can heal with 4-6 weeks in a thumb spica cast, but complete tears (especially Stener lesions where the torn ligament flips over and can't heal on its own) require surgery to reattach the ligament within 2-3 weeks, otherwise leading to chronic thumb instability, weak pinch strength, and early arthritis if left untreated.
Glomus Tumor (Fingernail Tumor Causing Severe Pain)
A glomus tumor is a small benign (non-cancerous) vascular tumor, most commonly occurring under the fingernail (subungual), causing a classic triad of symptoms: severe localized pinpoint pain, extreme sensitivity to cold (touching cold objects causes excruciating pain), and exquisite point tenderness when pressing on the affected spot. Despite being tiny (usually 2-5mm), these tumors cause disproportionate pain that often disrupts sleep and significantly affects quality of life, sometimes for years before diagnosis. Treatment is surgical removal of the tumor, which is curative in 90%+ of cases with immediate pain relief, though 10-15% recur if tumor not completely excised.
Finger Cyst from Arthritis (Mucous Cyst)
Mucous cysts (digital mucoid cysts) are small, fluid-filled bumps that develop on the finger (or rarely toe) near the fingernail, arising from the DIP (distal interphalangeal) joint—the joint closest to the fingertip—typically in people over 50 years with underlying finger arthritis. These cysts appear as translucent, dome-shaped lumps 3-10mm in size, filled with clear, jelly-like fluid (synovial fluid and mucin from the arthritic joint), and commonly cause nail deformity (groove running down nail if cyst presses on nail bed). While benign and not dangerous, they can be cosmetically bothersome or occasionally rupture and become infected. Treatment options range from observation (many patients tolerate them) to aspiration (temporary relief, 50-70% recurrence) to surgical excision with removal of underlying bone spur (90% cure rate but requires minor surgery under local anaesthetic).
Arthritis of the Middle Finger Joints
PIP (proximal interphalangeal) joint arthritis is wear-and-tear arthritis affecting the middle knuckle joints of the fingers - it causes pain, stiffness, swelling, and bony lumps (Bouchard's nodes) making it difficult to bend fingers or grip objects - most common in people over 50 years old, especially women - conservative treatment (splinting, anti-inflammatory medication, corticosteroid injections) manages symptoms in 60-70% of patients, while severe arthritis limiting hand function can be treated with surgery (joint replacement preserving motion or fusion eliminating motion but providing pain relief and stability).
Thumb Arthritis (Base of Thumb)
Thumb arthritis at the base of your thumb causes pain with gripping and pinching. Learn about symptoms, splinting, injections, and surgical options to relieve thumb pain.
Trigger Finger
Trigger finger causes your finger to catch or lock when you bend it. Learn about symptoms, steroid injections, and surgical release to restore smooth finger movement.
Thigh
Thigh Bone Fractures Near the Knee
Distal femur fractures are breaks in the thighbone just above the knee joint, commonly occurring from high-energy trauma (car accidents, falls from height) in young people or low-energy falls in older adults with osteoporosis - these fractures cause severe knee pain, swelling, inability to bear weight, and visible deformity - most require surgery with metal plates, screws, or rods to realign and stabilize the bone, with recovery taking 3-6 months and good outcomes in 75-85% of patients achieving return to walking and daily activities
Limb Lengthening (Distraction Osteogenesis)
Surgical technique to lengthen bones or correct deformities by gradually pulling apart cut bone, stimulating new bone formation through controlled mechanical tension - used for limb length discrepancies, short stature, and bone defects
Blood Clots in the Leg (Deep Vein Thrombosis)
Deep vein thrombosis (DVT) is a blood clot forming in the deep veins of the leg, commonly occurring after surgery, prolonged immobility, or injury - DVT causes calf pain, swelling, warmth, and redness in one leg - the main danger is the clot breaking off and traveling to the lungs (pulmonary embolism), which can be life-threatening - diagnosis involves ultrasound scanning of leg veins - treatment requires blood-thinning medications for 3-6 months, with 90-95% of patients recovering fully without long-term complications if treated promptly
Hamstring Injuries
Hamstring injuries cause sudden pain in the back of your thigh, usually during running or sprinting. Learn about grades of hamstring strains, treatment from rest to surgery, and how to prevent re-injury.
Bone Growing in Muscle After Injury (Myositis Ossificans)
Myositis ossificans is a condition where bone forms inside muscle tissue after a direct blow or injury - it most commonly occurs in the thigh (quadriceps) or upper arm (brachialis) muscles after a hard impact, creating a painful lump that gradually hardens as bone develops over weeks to months - the key to treatment is recognizing it early and avoiding aggressive massage, stretching, or early surgery which make it worse - conservative treatment (rest, gentle motion, anti-inflammatory medication) allows the bone to mature over 6-12 months, after which it can be surgically removed if causing problems, achieving 70-80% good outcomes.
Quadriceps Contusion (Cork Thigh / Dead Leg)
Bruised thigh muscle from direct impact causing pain, swelling, and difficulty walking. Learn about mild/moderate/severe grading, myositis ossificans risk, treatment protocols, and safe return to sport after a cork thigh.
Quadriceps Tendinitis (Jumper's Knee at Thigh)
Quadriceps tendinitis causes pain above the kneecap where the powerful thigh muscle attaches. Common in jumping athletes and runners, it responds well to physiotherapy and gradual activity modification.
Quadriceps Tendon Rupture (Torn Quad Tendon)
A complete tear of the quadriceps tendon above the kneecap, requiring urgent surgical repair. Learn about symptoms, surgery, and the 6-9 month recovery process.